White Coat, Mood Indigo — Depression in Medical School

Rosenthal, Julie; Okie, Susan

doi:10.1056/nejmp058183

Cited by 170 publications

(144 citation statements)

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“…Todavia, essa preocupação termina não se refletindo em estratégias objetivas de combate às situações patológicas, na medida em que poucas são as publicações de resultados sobre o tema, quando comparamos com o número de estudos preocupados com a detecção de sintomas ou transtornos, principalmente depressivos [26][27][28][29] .…”

Section: Discussionunclassified

“…No estudo de Moro et al 25 , os parâmetros utilizados foram semelhantes àqueles aqui utilizados e estiveram em conformidade com estudos que situam ponto de corte igual ou acima de 17 pontos como passível de ser correlacionado com depressão maior 30 . Os dados por nós encontrados estão também percentualmente próximos de outras pesquisas 6,7,26,31,32 .…”

Section: Discussionunclassified

“…Nossos dados mostram um maior percentual de mulheres com sintomas depressivos -33,5 contra 19% de homens -, o que está de acordo com o encontrado em outros estudos e na população em geral 2,6,17,25,26 .…”

Section: Discussionunclassified

“…Alguns fatores identificados em outros estudos estão também aqui presentes, dentre os quais: a entrada no hospital, com o contato mais direto com pacientes graves e com a morte; a alta exigência das disciplinas teórico-práticas, que os obriga a maior número de horas de estudo; fadiga; exigência de participação em atividades médicas extracurriculares, como as ligas acadêmicas; disputas entre os próprios alunos por melhores colocações em serviços ou atividades acadêmicas 1,2,6,17,18,25,26,32 . A redução na taxa de prevalência do quarto para o quinto ano e um discreto recrudescimento no sexto ano parece consentânea com a angústia do término do curso e o preparo, simultâneo ao internato, para a prova de residência médica.…”

Section: Discussionunclassified

“…Deve ser considerado importante o fato de que 7,9% dos alunos já tiveram idéias sobre se matar (item 9 do BDI), pois mesmo não sendo este um dos objetivos desta investigação (avaliar comportamento suicida nos alunos), outros estudos mostram essa preocupação, uma vez que encontram uma tendência ao suicídio entre estudantes de medicina em percentual maior do que aquele encontrado na comunidade em geral 4,7,17,26 .…”

Section: Discussionunclassified

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Sintomas depressivos em acadêmicos de medicina da Universidade Federal de Goiás: um estudo de prevalência

Amaral

Gomide

Batista

et al. 2008

Rev. psiquiatr. Rio Gd. Sul

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ResumoIntrodução: O presente estudo teve como objetivo investigar a prevalência de sintomas depressivos em alunos de medicina da Universidade Federal de Goiás, comparando com a população em geral e verificando a possibilidade de determinado período do curso atuar como fator de risco. Método: Estudo transversal, descritivo, de amostra representativa de alunos regularmente matriculados na Faculdade de Medicina da Universidade Federal de Goiás. Foram selecionados 287 alunos do primeiro ao sexto ano através de sorteio aleatório simples. Utilizou-se, para avaliação, o Inventário de Depressão de Beck e um questionário de identificação. Resultados: Na população entrevistada, 26,8% apresentaram sintomas depressivos de acordo com escores do Inventário de Depressão de Beck estabelecidos para este estudo. A prevalência de sintomas depressivos moderados e graves entre os entrevistados foi de 6,9%, enquanto 19,9% apresentaram sintomas leves. Em relação ao sexo, encontrou-se 33,5% de mulheres e 19% de homens com sintomas depressivos. Em relação ao ano em curso, houve maior prevalência entre os alunos do terceiro e do quarto ano. Tristeza, anedonia, baixa auto-estima, perfeccionismo, irritabilidade, desinteresse por pessoas, redução da capacidade de trabalho e cansaço excessivo foram os itens do Inventário de Depressão de Beck mais pontuados. Conclusão: A prevalência de sintomas depressivos encontrada neste estudo é superior à média encontrada na população em geral, havendo indicativo de que a escola médica possa ser um fator predisponente para tais sintomas. Descritores: Acadêmicos de medicina, depressão, prevalência, prevenção. AbstractIntroduction: The objective of the present study was to assess the prevalence of depressive symptoms among medical students of Universidade Federal de Goiás, Brazil, comparing them to the general population and investigating the possibility of a certain period throughout the course being a risk factor. Method: A cross-sectional descriptive study of a representative sample of students regularly enrolled at the Medical School of Universidade Federal de Goiás was performed. A total of 287 students from the first to sixth year were selected using simple random drawing. The Beck Depression Inventory and an identification questionnaire were used for evaluation.

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Sintomas depressivos em acadêmicos de medicina da Universidade Federal de Goiás: um estudo de prevalência

Amaral

Gomide

Batista

et al. 2008

Rev. psiquiatr. Rio Gd. Sul

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Depression, Stigma, and Suicidal Ideation in Medical Students

Schwenk¹,

Davis²,

Wimsatt³

2010

JAMA

543

426

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EDICAL STUDENTS EXPERIence depression, burnout, and mental illness at a higher rate than the general population, with mental health deteriorating over the course of medical training. [1][2][3][4][5][6] Medical students have a higher risk of suicidal ideation 7 and suicide, 8 higher rates of burnout, 6,9 and a lower quality of life than age-matched populations. 5,10 Burnout and depressive symptoms have been associated with suicidal ideation. 4,6,9,10 Medical students are less likely than the general population to receive appropriate treatment despite seemingly better access to care. [11][12][13] Students may engage in potentially harmful methods of coping, such as excessive alcohol consumption, and, despite their training, may fail to recognize that depression is a significant illness that requires treatment. 11 Stigma associated with depression and the use of mental health care services may represent a barrier to seeking treatment. 2,[12][13][14] One study identified stigma as an explicit barrier to the use of mental health services by 30% of first-and second-year medical students experiencing depression. In addition, 37% identified lack of confidentiality and 24% cited fear of documentation in their academic record as barriers to treatment. 2 Students may worry that revealing their depression will make them less competitive for residency training positions or compromise their education, 2,12,13 and physicians may be reluctant to disclose their diagnosis on licensure and medical staff applications. 15,16 The fear of professional sanctions may lead to inappropriate and possibly dangerous approaches to seeking care such as selfprescription of antidepressants. 17 No studies to our knowledge have addressed in more specific detail the perceptions of stigma by depressed medical students that may serve as barriers to receiving appropriate mental health care.We conducted a study of medical students at the University of Michigan Medical School to assess the prevalence of self-reported depression and suicidal ideation and to assess the per-See also pp 1173 and 1231.

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Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical Students

Rotenstein

Ramos

Torre

et al. 2016

JAMA

1,746

1,409

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IMPORTANCE Medical students are at high risk for depression and suicidal ideation. However, the prevalence estimates of these disorders vary between studies.OBJECTIVE To estimate the prevalence of depression, depressive symptoms, and suicidal ideation in medical students.DATA SOURCES AND STUDY SELECTION Systematic search of EMBASE, ERIC, MEDLINE, psycARTICLES, and psycINFO without language restriction for studies on the prevalence of depression, depressive symptoms, or suicidal ideation in medical students published before September 17, 2016. Studies that were published in the peer-reviewed literature and used validated assessment methods were included.DATA EXTRACTION AND SYNTHESIS Information on study characteristics; prevalence of depression or depressive symptoms and suicidal ideation; and whether students who screened positive for depression sought treatment was extracted independently by 3 investigators. Estimates were pooled using random-effects meta-analysis. Differences by study-level characteristics were estimated using stratified meta-analysis and meta-regression. MAIN OUTCOMES AND MEASURESPoint or period prevalence of depression, depressive symptoms, or suicidal ideation as assessed by validated questionnaire or structured interview.RESULTS Depression or depressive symptom prevalence data were extracted from 167 cross-sectional studies (n = 116 628) and 16 longitudinal studies (n = 5728) from 43 countries. All but 1 study used self-report instruments. The overall pooled crude prevalence of depression or depressive symptoms was 27.2% (37 933/122 356 individuals; 95% CI, 24.7% to 29.9%, I 2 = 98.9%). Summary prevalence estimates ranged across assessment modalities from 9.3% to 55.9%. Depressive symptom prevalence remained relatively constant over the period studied (baseline survey year range of 1982-2015; slope, 0.2% increase per year [95% CI, −0.2% to 0.7%]). In the 9 longitudinal studies that assessed depressive symptoms before and during medical school (n = 2432), the median absolute increase in symptoms was 13.5% (range, 0.6% to 35.3%). Prevalence estimates did not significantly differ between studies of only preclinical students and studies of only clinical students (23.7% [95% CI, 19.5% to 28.5%] vs 22.4% [95% CI, 17.6% to 28.2%]; P = .72). The percentage of medical students screening positive for depression who sought psychiatric treatment was 15.7% (110/954 individuals; 95% CI, 10.2% to 23.4%, I 2 = 70.1%). Suicidal ideation prevalence data were extracted from 24 cross-sectional studies (n = 21 002) from 15 countries. All but 1 study used self-report instruments. The overall pooled crude prevalence of suicidal ideation was 11.1% (2043/21 002 individuals; 95% CI, 9.0% to 13.7%, I 2 = 95.8%). Summary prevalence estimates ranged across assessment modalities from 7.4% to 24.2%. CONCLUSIONS AND RELEVANCEIn this systematic review, the summary estimate of the prevalence of depression or depressive symptoms among medical students was 27.2% and that of suicidal ideation was 11.1%. Further research is nee...

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White Coat, Mood Indigo — Depression in Medical School

Abstract: A s the head of student government at Duke University School of Medicine in Durham, North Carolina, Sujay Kansagra had witnessed several of his fellow students dealing with depression. "I knew

Cited by 170 publications

References 3 publications

Sintomas depressivos em acadêmicos de medicina da Universidade Federal de Goiás: um estudo de prevalência

Sintomas depressivos em acadêmicos de medicina da Universidade Federal de Goiás: um estudo de prevalência

Depression, Stigma, and Suicidal Ideation in Medical Students

Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical Students

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